应用心电图“镜像”改变判断急性下壁心肌梗死相关动脉  

Predictive value of "minor" changes on lateral wall leads during inferior wall acute myocardial infarction

作　　者：赵玉萍[1] 张炜平[1] 李金泉[2] 

机构地区：[1]天津海河医院,300350 [2]天津第三中心医院,300350

出　　处：《临床心电学杂志》2008年第5期344-345,共2页Journal of Clinical Electrocardiology

摘　　要：目的分析急性下壁心肌梗死侧壁导联心电图呈"镜像"改变对梗死相关动脉的判定。方法根据87例急性下壁心肌梗死患者侧壁导联心电图有无"镜像"改变,对比其与冠状动脉造影显示梗死相关动脉的关系。结果I,aVL导联出现"镜像"改变对判断急性下壁心肌梗死相关动脉为右冠状动脉的敏感性分别为63.0%和94.5%,特异性分别为76.9%和61.5%(p<0.05),aVL导联无镜像改变对判断梗死相关动脉为回旋支的阳性预测值为66.7%,阴性预测值为93.2%。结论急性下壁心肌梗死时,I和aVL导联呈"镜像"改变是判断梗死相关动脉为右冠状动脉的较敏感指标,由以aVL导联更敏感。aVL导联无"镜像"改变是判断梗死相关动脉为回旋支的较好指标。Objective Analysis the predictive value of ＂minor＇changes on lateral wall leads during inferior wall acute myocardial infarction. Methods Compare the ＂minor＂ changes in lateral wall leads with the infarction related artery in 87 patients with inferior wall acute mycardial infarction. Results ＂minor＂changs in lead I and aVL indicates right coronary artery associated inferior wall acute myocardial infarction with a sensitivity of 63.0% and 94.5%（p〈 0.05）, and speccificity of 76.9% and 61.5% （p〈0.05）. No ＂minor＂ changes in lead aVL predicts left circumflex artery associated inferior wall acute myocardial infarction with positive predictive value of 66.7% and negative predictive value of 93.2%. Conclusion ＂minor＂ changes in lead I and aVL is a sensitive sign to identify right coronary artery associated inferior wall acute myocardial infarction being infarction related artery, and lead aVL is a even sensitive sign.No ＂minor＂ chang in lead aVL is a good sign to identify left circumflex artery being infarction related artery.

关 键 词：急性心肌梗死 心电图 梗死相关动脉 

分 类 号：R542.22[医药卫生—心血管疾病]